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Accessing an abortion in Australia just got a bit easier

Physician Emma Boulton is director of Clinic 66 in Sydney. (Stephanie Simcox for The Washington Post)
6 min

SYDNEY — Access to abortion became easier in Australia on Thursday as decriminalization took effect in South Australia state, part of a wave of liberalization that contrasts with recent moves in the United States.

For the most part, abortion is not the subject of polarizing national debate Down Under, as it often is in American politics. But the U.S. Supreme Court’s decision to overturn Roe v. Wade shocked many Australians, leading thousands to attend rallies in support of abortion rights.

“It never really gets a lot of attention, and this is the most attention that it’s gotten,” said Daile Kelleher, chief executive officer of Children by Choice, based in Brisbane. “This is probably a bit of a watershed moment in Australia where people are showing that they care about this.”

While pregnancy terminations are legal in each of the country’s eight states and territories, people often face difficulties of access, especially outside major cities, reproductive health experts say. “Abortion is a zip-code lottery,” said Bonney Corbin, head of policy at provider MSI Australia.

In many countries, abortion is protected by law, not court decision

Getting one can be especially expensive for those not covered by Australia’s universal health insurance, such as some migrant workers, she said, and travel costs can pose an added burden.

But the South Australian changes should lower barriers, allowing abortion to be provided on demand while regulating it through health law rather than the criminal code. Any doctor — or nurse, in the case of a medical termination — can provide an abortion up to 23 weeks into a pregnancy.

Previously, terminations could be done there legally only in a handful of hospitals, mostly in the state capital, Adelaide, with the approval of two doctors, and only for patients who had been living in the state for at least two months. Both doctors had to agree that the patient’s physical or mental health would be at risk without an abortion or that the child would be born “severely handicapped.”

The change also allows patients to complete abortions at home via telehealth consultations with interstate providers.

“It’s a big day, and it’s important for South Australian women and providers that abortion is treated more like other health care,” said Brigid Coombe, co-convener of the South Australian Abortion Action Coalition.

Across the country in Sydney, sexual health center Clinic 66 was preparing to accept new patients on a rainy day this week. As of Thursday, the clinic can prescribe MS-2 Step, a package of two medications that trigger a miscarriage, to patients nationwide.

Outside, the street was quiet. There were no protesters brandishing dolls and pamphlets; it’s illegal to picket or harass people at an abortion provider. Inside, women slouched in brown leather chairs, scrolling on their phones in the waiting room as receptionists talked on the phone. But much of the clinic’s work was happening outside the building.

On Monday, two doctors performed 20 telehealth consultations for abortions via the clinic’s online portal. One doctor was in Newcastle, in New South Wales, the other 620 miles away, on Victoria’s Mornington Peninsula. One patient was from a small town in Queensland, another from the national capital, Canberra. The doctors sent digital prescriptions for MS-2 Step for patients to take to their pharmacies, enabling them to complete an abortion at home. In some cases, the clinic mails medication to patients directly.

“We’ve had so many clients who were just incredibly grateful for that care,” said Emma Boulton, the clinic’s director. “It’s really rewarding to be able to look after women.”

Until now, South Australian patients had been driving to Victoria to access abortion via telehealth consultation, Boulton said. “But women really value being able to do this in the privacy of their own home,” she added.

U.S. abortion decision draws cheers, horror abroad

Almost 60 percent of Australians believe a woman should always be able to obtain a termination if that is her choice, according to a 2019 poll by the University of Sydney’s United States Studies Center that revealed a range of more liberal attitudes compared with those of Americans. Religion seemed to be a factor, the study’s authors said at the time; census results released last month also showed Australia to be secularizing rapidly, with almost 40 percent of people declaring no religion, up from 22 percent a decade earlier.

“You can say that we’re going in opposite directions” on abortion, said Gwen Gray, a political scientist specializing in reproductive rights at Australian National University.

Yet the liberalization is relatively recent. Two years ago, women in Tasmania reported flying to the mainland for surgical abortions because it was easier than getting one in the island state. Now, the conservative state government has made the procedure available in three public hospitals.

Four years ago in Queensland, abortion was illegal except in cases that seriously threatened the mother’s physical or mental health. In 2010, the state took a young couple to trial — they were acquitted — after the woman had an abortion with MS-2 Step medication. Now, public health services are legally required to provide a pathway to a termination for any patient, and the procedure is available at many public hospitals.

Abortion was decriminalized in the Northern Territory in 2017, New South Wales in 2019, and now, in South Australia. But patients in some areas still face hurdles.

In Western Australia, one doctor must refer a patient to a second doctor, who will provide the abortion. After 20 weeks’ gestation, the patient must sit before a panel of up to six experts, two of whom must agree to allow the termination.

In Queensland, Kelleher said, pregnant people who contacted her had reported some health workers flouting legal requirements by declining to help them with an abortion or refusing to refer them to someone who would. And delays within hospitals could be lengthy, she said, citing a recent case in which a woman ended up giving birth despite seeking an abortion at nine weeks.

Coombe said that the battle for equitable access wasn’t over, and that the overturning of Roe crystallized for many the need to protect their rights.

“It certainly made the public sit up and take notice,” she said.